Individual provider Active NPI

Kristina G. Landry, N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Ville Platte, LA
National Provider Identifier
1639185671
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP04414 Issued in LA
Practice address
1257 Mayeauxville Rd
Ville Platte, LA 70586-8409
Phone
(337) 506-2294
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP04414 LA Primary
Family Nurse Practitioner 363LF0000X AP04414 LA

Addresses

Primary practice location

1257 Mayeauxville Rd
Ville Platte, LA 70586-8409

Mailing address

1008 W Main St
Ville Platte, LA 70586-4208
Phone (337) 506-2294

Other identifiers 1

IdentifierTypeStateIssuer
1342416MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041102000066 LA Practitioner - Nurse Practitioner 1254393218 Reassigns benefits to 2 organizations
Practice locations: Alexandria, LA; Jena, LA; Ville Platte, LA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vital Healthcare Solutions LLCGroup PAC ID 9133598055, 14 clinicians

Practice addresses (Care Compare)

1257 Mayeauxville Rd
Ville Platte, LA 70586-8409
Phone (337) 831-1704

724 W Magnolia St
Ville Platte, LA 70586-4320
Phone (337) 506-2294

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP04414LAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vital Healthcare Solutions LLC CurrentSince Sep 6, 2022 Accepting new patients
Wellspring Wound Care, LLC Past Accepting new patients
LLC-II, LLC Past Accepting new patients
La Bonne Vie Family Healthcare & Aesthetics, LLC PastSince Dec 14, 2016 Accepting new patients
Mdhpx, LLC Family PastSince Sep 5, 2021 Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Magnolia TherapeuticsVille Platte, LA, CCN 198909 Rural health clinic 5% Or Greater Direct Ownership Interest (50%)
General Partnership Interest (50%)
Corporate Officer (50%)
Operational/Managerial Control (50%)
Sep 6, 2022
Sep 6, 2022
Sep 6, 2022
Sep 6, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1639185671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 W MAIN ST",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "705864208",
            "telephone_number": "337-506-2294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1257 MAYEAUXVILLE RD",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "705868409",
            "telephone_number": "337-506-2294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "KRISTINA",
        "middle_name": "G.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "AP04414",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP04414",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1342416",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ville Platte, LA

Sources for this page

Verify at the official NPI Registry.